Calle E E, Mervis C A, Wingo P A, Thun M J, Rodriguez C, Heath C W
Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA, USA.
Cancer Causes Control. 1995 Sep;6(5):460-8. doi: 10.1007/BF00052187.
Controversy exists over the possible relationship between induced and spontaneous abortion and risk of breast cancer. Thus, the association of fatal breast cancer and spontaneous abortion was examined in a large prospective study of United States adult women. After seven years of follow-up, 1,247 cases of fatal breast cancer were observed among 579,274 women who were cancer-free at interview in 1982 and who provided complete reproductive histories. Results from Cox proportional hazards models, adjusted for other risk factors, showed no association between a history of spontaneous abortion and risk of fatal breast cancer (rate ratio [RR] = 0.89, 95 percent confidence interval [CI] = 0.78-1.02). The RR did not increase with increasing numbers of abortions. Parous women who had a spontaneous abortion before their first term birth were not at increased risk compared with parous women with no history of spontaneous abortion (RR = 0.76, CI = 0.54-1.05). Women whose only pregnancy ended in a spontaneous abortion were not at increased risk compared with women who were never pregnant (RR = 0.61, CI = 0.27-1.38) or whose only pregnancy ended in a livebirth (RR = 0.72, CI = 0.32-1.65). These findings do not support an association between spontaneous abortion and fatal breast cancer.
人工流产与自然流产和乳腺癌风险之间的可能关系存在争议。因此，在美国成年女性的一项大型前瞻性研究中，对致命性乳腺癌与自然流产之间的关联进行了研究。经过七年的随访，在1982年接受访谈时无癌症且提供了完整生育史的579,274名女性中，观察到1,247例致命性乳腺癌病例。经其他风险因素调整后的Cox比例风险模型结果显示，自然流产史与致命性乳腺癌风险之间无关联（率比[RR]=0.89，95%置信区间[CI]=0.78 - 1.02）。RR并未随着流产次数的增加而升高。与无自然流产史的经产妇相比，首次足月分娩前有自然流产史的经产妇风险并未增加（RR = 0.76，CI = 0.54 - 1.05）。与从未怀孕的女性（RR = 0.61，CI = 0.27 - 1.38）或唯一一次怀孕以活产告终的女性（RR = 0.72，CI = 0.32 - 1.65）相比，唯一一次怀孕以自然流产告终的女性风险并未增加。这些发现不支持自然流产与致命性乳腺癌之间存在关联。
